What is sinusitis?

Sinusitis is an inflammation of the mucus membranes lining the sinus cavities. Acute sinusitis is a short-term condition that usually responds well to antibiotics and decongestants; chronic sinusitis is characterized by multiple or continuous infections. Either medication or surgery is a possible treatment.

How common is sinusitis?

More than 37 million Americans suffer from at least one episode of sinusitis each year. The prevalence of sinusitis has soared in the last decade possibly due to increased pollution, urban sprawl, and heightened resistance to antibiotics.

How is acute sinusitis treated?

Acute sinusitis is generally treated with 10 to 14 days of oral antibiotic care. With treatment, the symptoms gradually disappear. Oral and topical decongestants also may be prescribed to alleviate the symptoms. Studies show that nasal rinsing with a hypertonic solution may help improve symptoms.

What are the signs and symptoms of chronic sinusitis?

Victims of chronic sinusitis may have the following symptoms for 12 weeks or more: facial pain/pressure, facial congestion/fullness, nasal obstruction/blockage, thick nasal discharge/discolored post-nasal drainage, pus in the nasal cavity, and at times, fever. They may also have headache, bad breath, and fatigue.

What measures can be taken at home to relieve sinus pain?

Warm moist air may alleviate sinus congestion. Experts recommend a vaporizer or steam from a pan of boiled water. (The pan should be removed from the heat.) Facial “misters” can also be helpful. Humidifiers require meticulous cleaning and maintenance to avoid spraying bacteria or fungal spores into the air. Rinsing the sinuses with a saline solution is also helpful.

How effective are non-prescription nose drops or sprays?

Use of nonprescription drops or sprays might help control symptoms. However, extended use of non-prescription decongestant nasal sprays could aggravate symptoms leading to further problems. They should not be used beyond their label recommendation, which is usually three days. Saline nasal sprays or drops are safe for continuous use.

How does a physician determine the best treatment for acute or chronic sinusitis?

To obtain the best treatment option, the physician needs to properly assess the patient’s history and symptoms and then progress through a structured physical examination often including nasal endoscopy, bacterial cultures and CT Scanning.

What should one expect during the physical examination for sinusitis?

At a specialist’s office, the patient will receive a thorough ear, nose, and throat examination. The physician may feel and press over the sinuses for pain and tenderness. Additionally, the physician may tap the teeth to help identify an inflamed maxillary sinus.

What other diagnostic procedures might be taken?

Other diagnostic tests may include a nasal endoscopy, bacterial culture, allergy testing, or CT scan of the sinuses.

What is nasal endoscopy?

An endoscope is a delicate fiber optic instrument used to examine the interior of the nose. It allows a visual examination of the nose and sinus drainage areas.

Why does an ear, nose, and throat specialist perform nasal endoscopy?

Nasal endoscopy offers the physician specialist a reliable view of all the sinus drainage pathways. First, the patient’s nasal cavity is anesthetized; a rigid or flexible endoscope is then placed in a position to view the nasal cavity. The procedure is utilized to observe signs of obstruction and inflammation and to detect nasal polyps hidden from routine nasal examination. During the endoscopic examination, the physician specialist also looks for indication of infection as well as polyp formation and structural abnormalities that may cause sinusitis. Cultures may be taken so that the most appropriate antibiotics may be recommended.

What course of treatment will the physician recommend?

To reduce congestion, the physician may prescribe such products as nasal sprays, drops, regular nasal cleansing, or oral decongestants. Antibiotics will be prescribed for bacterial infection found in the sinuses. (Antibiotics are not effective against a viral infection.) Antihistamines may be recommended for the treatment of allergies.

Will any changes in lifestyle be suggested during treatment?

Smoking is never condoned, but if one does smoke, it is important to refrain during treatment for sinus problems. Drinking extra fluids helps to thin mucus. Reducing acid reflux causing foods is also helpful.

When is sinus surgery necessary?

Mucus is produced by the body to act as a lubricant and cleanser. In the sinus cavities, the lubricant is moved across mucous membrane toward the opening of each sinus by millions of microscopic hair-like cilia. Inflammation causes membrane swelling and the sinus opening to narrow, thereby blocking mucus movement and infection often results. Tissue inflammation caused by allergies, irritants, mold or viral infections can block the sinus openings. This forces the mucus to collect within the sinuses and become secondarily infected with bacteria. If medical treatment fails to open the sinuses, the infections can persist and recur. Surgery is often recommended in this situation.

What does the surgical procedure entail?

The basic endoscopic surgical procedure is an outpatient procedure performed under local or general anesthesia. The patient returns to normal activities within several days.

What does sinus surgery accomplish?

Modern, minimally invasive surgery should remove only severely damaged tissue enlarging the natural outflow tracts to the sinuses, leaving as much tissue and cilia in place as possible to regenerate normal tissue. Otolaryngologists – head and neck specialists – have found endoscopic surgery to be highly effective in restoring normal function to the sinuses. The procedure removes areas of obstruction, facilitating the normal flow cleansing of mucus.

What are the consequences of not treating infected sinuses?

Not seeking treatment for sinusitis will result in unnecessary pain and discomfort. A minor acute infection can develop into chronic sinusitis if not treated. In rare circumstances, infection may spread leading to meningitis or brain abscess.